Risk Factors of Carbapenemase-Producing Enterobacterales Acquisition Among Adult Intensive Care Unit Patients at a Kentucky Academic Medical Center

Details

• Personal Author:
  Forster D ; Sanderson, Wayne T. ; Westgate PM ; Wilson JE ; Winter K
• Description:
  Background: Acquisition of carbapenemase-producing carbapenem-resistant Enterobacterales (CP-CRE) are associated with negative health outcomes. Our adult intensive care unit (ICU) population has experienced low levels of CP-CRE acquisition; however, specific risk factors for this population at our medical facility have not been studied. Aims: To identify risk factors of CP-CRE acquisition and describe CP-CRE epidemiology among adult ICU patients at our medical facility. Methods: A retrospective cohort study was performed at a Kentucky Academic Medical Center. Surveillance specimens were collected at admission and weekly thereafter to identify CP-CRE colonization. Clinical data were extracted from patient medical records. Cases were defined as those who tested positive for CP-CRE on ICU admission day 3 or greater. Risk of CP-CRE acquisition was calculated using Modified Poisson regression. Findings: Independent risk factors of CP-CRE acquisition included administration of enteral tube feeds (risk ratio [RR], 4.46; 95% confidence interval [CI], 1.74-11.43); diagnosis of Clostridioides difficile enterocolitis (RR, 3.51; 95% CI, 1.27-9.68), pressure ulcer (RR, 3.48; 95% CI, 1.91-6.36), and morbid obesity (RR, 2.10; 95% CI, 1.12-3.95); having a drainage tube (RR, 2.63; 95% CI, 1.38-4.98); admission to a medical ICU (RR, 2.39; 95% CI, 1.32-4.35); 90-day use of a carbapenem (RR, 2.27; 95% CI, 1.21-4.26); and dialysis procedure (RR, 2.22; 95% CI, 1.15-4.27). Conclusion: Most CP-CRE risk factors were associated with alteration of colon microbiota and/or invasive procedures/devices. These results will assist in creating a more targeted CP-CRE active surveillance system and highlight areas for infection prevention intervention. [Description provided by NIOSH]
• Subjects:
  Cohort Studies Communicable Diseases Epidemiology Health Care Facilities Workforce And Services Occupational Health Safety
• Keywords:
  Author Keywords: CRE Bacterial Cultures Carbapenem Carbapenemase Cohort Studies ICU Infection Control Infectious Diseases MDRO Medical Facilities Surveillance

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• ISSN:
  2590-0889
• Document Type:
  Text
• Funding:
  Cooperative Agreement
• Genre:
  Journal Article
• Place as Subject:
  Kentucky ; OSHA Region 4
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  5
• Issue:
  4
• NIOSHTIC Number:
  nn:20069780
• Citation:
  Infect Prev Pract 2023 Dec; 5(4):100310
• Contact Point Address:
  Jason Eric Wilson, Infection Preventionist at Tampa General Hospital, 7511 Tangle Rush Dr., Gibsonton, FL, 33534, USA
• Email:
  ericwilson@tgh.org
• Federal Fiscal Year:
  2024
• NORA Priority Area:
  Agriculture, Forestry and Fishing
• Performing Organization:
  University of Kentucky
• Peer Reviewed:
  True
• Start Date:
  20010930
• Source Full Name:
  Infection Prevention in Practice
• End Date:
  20270929
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:f24a82206b16c865d5d9acfcafc1cc697afdaeeb2309b7cbb274c9717b6ba00ef3328c04824e88c40a54e09d13aefed4a87daf8faa14176ef00bc727308f2b93
• Download URL:
  https://stacks.cdc.gov/view/cdc/208136/cdc_208136_DS1.pdf
• File Type:
  [PDF - 552.58 KB ]